Macular hole is a full-thickness retinal defect that originates in the macula. It affects less than 1% of the population, predominantly in the population between 50 and 80 years of age, especially in women.
Ophthalmic specialists note that this pathology occurs due to the traction forces associated with the detachment of the perifoveal vitreous.
Symptoms of macular hole
The main symptoms presented by this pathology are:
- Decreased visual acuity of variable degree: depending on the size of the hole, the location of the hole with respect to the foveola and the size of the associated neurosensory retinal detachment.
- Central scotoma: sensation of a spot in the fixation field.
- Metamorphopsia: deformation of straight lines and objects in general.
The diagnosis of macular hole is made by biomicroscopic examination assisted by precorneal examination lenses. At present, the most useful comprehensive test is optical coherence tomography (OCT). It allows precise quantification of the details related to the hole.
Macular hole: treatment
In some early stage cases, close monitoring should be performed, as spontaneous closure may occur in cases of stage 1 macular hole.
In general, the main treatment for this pathology is surgery. It consists of vitrectomy with complete removal of the central vitreous, posterior hyaloid and all epiretinal tissues, including the inner retinal limiting membrane. Once the vitrectomy is done, internal gas tamponade and prone positioning of the head is performed.